How is the Affordable Care Act Different from Medicare?

If Social Security and Medicare are constitutional, why isn’t the individual mandate from the Affordable Care Act also constitutional? Law professor Elizabeth Price Foley explains that the Social Security and Medicare laws are based on a different congressional power than the Affordable Care Act. Social Security and Medicare fall under Congress’s power to tax and spend on behalf of U.S. citizens, while the individual mandate is based on the power to regulate commerce.

The question before the Supreme Court is whether the power to regulate commerce includes the power to compel people to participate in commerce. Is it within Congress’s constitutional authority to require individuals to buy health care if they do not want to do so?

Professor Elizabeth Price Foley says Congress could have solved the problem of access to health care for the uninsured without using its commerce power. It could have simply invoked the same principle it used with Social Security and Medicare. If that had happened, the Affordable Care Act would not be in a case pending before the Supreme Court.

5 Comments

Chocolate Thunder

I suppose we now know it’s the case that SCOTUS found the individual mandate constitutional because of the taxing power, as suggested in this video.

But this is somewhat confusing to me. Would the Framers of the Constitution considered this to be admissible under the power to tax? Also, what limits are there to government if it can use the taxing power in such a way?

citizen1111

Holding the framers in such high esteem is somewhat difficult as they considered slavery acceptable. The only limit I can think of is the ballot box, but unfortunately we know how unproductive that is with the system as it currently exists

Stephen Dincher

The founders would definitely not have considered this admissible. The original constitution outlawed all direct taxes (income, property, and payroll taxes were all unconstitutional until 1908). So it’s pretty obvious that there would have been zero approval by the founders for this monstrosity of a bill, and medicare and social security would have been inadmissible as well.